Measles eradication hits funding, vaccination snags

Jun 15, 2011 (CIDRAP News) – A dramatic 78% drop in measles deaths since the start of the decade has global health officials eyeing eradicating the disease, but two major setbacks—resurgence of the disease in Africa and shrinking disease-fighting funds—threaten the efforts, experts said today.

They spelled out the opportunities and challenges to eradicating measles and controlling rubella in a commentary introducing a special Journal of Infectious Diseases supplement on the diseases published today.

The issue contains 71 reports that address public health implications of the diseases, eradication feasibility and economic issues, vaccines, regional experiences, and epidemiology and surveillance. The experts said the reports cover the successes that have led to the decreased burden of the diseases and the challenges that remain.

The measles and rubella supplement, published by the US Centers for Disease Control and Prevention (CDC), comes at a time when the disease threatens to gain a US foothold, due to recent travel-related exposure and lapses in childhood vaccination due to suspicions about vaccine safety.

Though the United States hasn't experienced endemic measles transmission since the 1990s, it is currently experiencing the highest number of measles cases since 1996, the CDC said in an e-mail press release to reporters today. So far 152 measles cases have been reported, 86% of them with links to international travel, the agency said.

The disease has killed 1,400 people in Africa since 2009 and sickened 30,000 people in Europe since 2010, the CDC noted.

At the same time, global health officials are buoyed by the recent declaration about rinderpest's eradication, which is only the second time the world has eradicated a disease, the first being smallpox.

Global measles experts, writing in the supplement's introduction, noted that measles vaccination efforts, led by an umbrella group called the Measles Initiative, have decreased childhood deaths by 24% since 2000, and that the progress has prompted the World Health Organization to explore the possibility of eradicating the disease.

However, the experts said eradication efforts experienced a setback in 2009 when several African countries experienced a widespread resurgence of measles due to vaccination gaps that have been worsened by declining immunization funds. The group wrote that financial support for the Measles Initiative shrunk from $150 million in 2007 to $35 million in 2010.

They said the world is at a crossroads about whether it can commit the political and financial resources to phase out the disease. "The availability of an inexpensive and effective vaccine makes measles immunization one of the most cost-effective public health interventions across a range of development settings," they wrote.